乳酸水平、外周血有核红细胞绝对计数联合振幅整合脑电图评分对早产儿脑损伤的预测价值

doi:10.3969/j.issn.1674-490X.2026.03.004

摘要/Abstract

摘要： 目的剖析振幅整合脑电图(amplitude integration electroencephalogram, aEEG)评分协同乳酸水平及外周血有核红细胞(nucleated red blood cell, NRBC)绝对计数指标在早产儿脑损伤早期诊断中的价值。方法选取2022年2月至2025年4月于河北大学附属医院产科出生并入住新生儿重症监护病房的207例早产儿为研究对象,根据头颅核磁共振成像结果分为脑损伤组(80例)和非脑损伤组(127例)。对比2组患儿的一般资料、aEEG评分、乳酸水平及出生后第1天、第3天NRBC绝对计数水平。结果脑损伤组aEEG评分［6.00(5.00, 7.00)］低于非脑损伤组［8.00(7.00, 9.00)］,乳酸水平［2.95(2.20, 4.85)］高于非脑损伤组［1.90(1.40, 2.50)］,出生后第1天NRBC绝对计数［1.12(0.44, 2.29)］高于非脑损伤组［0.39(0.26, 0.79)］(P<0.05)。Logistic回归分析显示,较高的aEEG评分是早产儿发生脑损伤的保护因素(P<0.05),较高的乳酸水平、出生后第1天NRBC绝对计数是早产儿发生脑损伤的危险因素(P<0.05)。受试者操作特征曲线显示,aEEG评分、乳酸水平及出生后第1天NRBC绝对计数单一评估早产儿脑损伤的曲线下面积(areaunder thecurve,AUC)分别为0.826、0.797、0.737,三者联合预测的AUC为0.892。结论 aEEG评分联合乳酸水平、外周血NRBC绝对计数可提高早产儿脑损伤的早期诊断效能,为临床干预提供参考。

关键词: 脑损伤, 振幅整合脑电图评分, 乳酸水平, 有核红细胞计数

Abstract: Objective To analyze the value of aEEG score combined with lactate(Lactic acid)level and absolute count of nucleated red blood cells(NRBC)in peripheral blood for early diagnosis of brain injury in preterm infants.Methods A total of 207 preterm infants born in the Obstetrics Department, Affiliated Hospital of Hebei University and admitted to the neonatal intensive care unit from February 2022 to April 2025 were selected as the research subjects. Subjects were stratified into a brain injury group(n=80)and a non-brain injury group(n=127)based on cranial magnetic resonance imaging(MRI)results.The general data, total aEEG score, lactate level, and absolute counts of NRBC on day 1 and day 3 after birth were compared between the two groups. Results The total aEEG score in the brain injury group was ［6.00(5.00, 7.00)］, lower than that ［7.00(8.00, 9.00)］in the non-brain injury group. The lactic acid level in the brain injury group was ［2.95(2.20, 4.85)］, higher than that ［1.90(1.40, 2.50)］in the non-brain injury group. The absolute count of NRBC on the 1st day after birth in the brain injury group was ［1.12(0.44, 2.29)］, higher than that ［0.39(0.26, 0.79)］ in the non-brain injury group(P<0.05).Logistic regression analysis showed that the higher aEEG score was a protective factor for brain injury in preterm infants(P<0.05), while higher lactate levels and absolute count of NRBC on day 1 after birth were risk factors for brain injury(P<0.05). ROC curve analysis showed that the areas under the curve(AUC)for single evaluation of brain injury by total aEEG score, lactate level, and absolute count of NRBC on day 1 after birth were 0.826, 0.797, and 0.737 respectively. The combined prediction of the three indicators achieved an AUC of 0.892. Conclusion The combination of aEEG score, lactate level, and absolute count of NRBC in peripheral blood can boost early diagnostic accuracy and efficiency for brain injury in preterm infants, providing a reference for clinical intervention.

Key words: brain injury, amplitude-integrated electroencephalography score, lactic acid level, nucleated red blood cell count

中图分类号:

汪灵,史群芳,王玉. 乳酸水平、外周血有核红细胞绝对计数联合振幅整合脑电图评分对早产儿脑损伤的预测价值[J]. 医学研究与教育, 2026, 43(3): 39-49.

Wang Ling, Shi Qunfang, Wang Yu. Predictive value of lactic acid level, peripheral blood nucleated red blood cell count combined with aEEG score for brain injury in premature infants[J]. Journal of Hebei Medical College for Continuing Education, 2026, 43(3): 39-49.

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